Having to kill another human being is traumatic enough. But when a child has to do it, either in defense of themselves, in defense of another, or being forced at gunpoint or swordpoint themselves to do it, the effect can be all the more horrifying. The fact that even children are forced to hand out violence in a setting to defend themselves adds to the cynicism of a setting. Children having to kill on a regular basis is a red flag for a Crapsack World.

The reasons for a child having to kill vary. They may have been attacked by someone and struck out in defense: they just happened to have the right thing on hand. Equally, they may manage to get the drop on someone who is trying to murder a parent or other carer. As mentioned before, they may be forced to do it, either as some form of Training from Hell or just from a complete sadist. This will be made all the more tragic if it was someone close to the character: a friend, relative or, worst of all, their own parent or even parents. If this is in a characters past, it will be a dark and troubled one.

Examples:

Happens in various Gundam franchises where the protagonists are young enough and the universe serious enough. Although combat is generally personified by mechas, the protagonists generally never forget that there is a person inside the war machine that is so easy to objectify, and spend time angsting over it.

In Gundam 00 the protagonist was brainwashed as a young child into becoming a member of a terrorist organisation. Part of the initiation involved killing his own parents.

Gunslinger Girl is all about this. The oldest girl is 16 and the youngest can't be older than 12, but they're all assassins.

Madlax has this as part of the Back Story: the plot stems from the fact that Margaret killed her own father (in self-defence) when she was 5 years old.

Killua from Hunter × Hunter is an example. Being a member of a Big Screwed-Up Family of assassins, he's taught to kill from infancy, and forced into the life of an assassin without being given much of any choice in the matter. He was murdering people before he turned 6, and by the time he appears in the show - at an age of maybe 10 or 11 - he's already killed hundreds of people.

In D.Gray-Man, the average age for an Exorcist seems to be late teens. Allen's fifteenish when things start, Lenalee's about the same but has been working as one since childhood, Lavi's eighteen, and Kanda has been an Exorcist since the day he was born due to certain experiments performed by the Order.

Elfen Lied: The Diclonius are all young girls. The iconic bloody first episode shows Lucy kill scores of men, and she's in her early teens. Several other Diclonii are forced to deal lethal attacks to each other throughout the series.

Trigun has this as Wolfwood's backstory. At a young age he kills his abusive guardian who happens to be his uncle and soon gets adopted by an assassin, who teaches him the Bible, and how to kill.

Berserk: Both Casca and Guts had to kill people in self-defense at a very young age as part of the backstory. In Guts' case, arguably twice; one was maybe more of a revenge thing, but given both that he was a kid and what the revenge was for, it could arguably still count as this.

Several characters in Attack on Titan feature this within their back story.

Mikasa was kidnapped by a gang of slavers, and was forced to help Eren kill them in self-defense. She's never the same.

Annie, Reiner, and Bertolt are the Tyke Bomb variant. Their mission required them to commit acts of mass murder, and all are shown to have suffered varying levels of trauma as a result. Reiner states they didn't even understand what they were doing at the time, and being allowed to go home is the one thing all three focus on to keep them going.

Some of the stuff that happened during the Grazton arc of The Tainted Grimoire was at least partly because Cid and Ensei wanted to avoid this trope. They now accept that given their circumstances, they can't avoid it and the younger members of Clan Gully will be ready for it should they have to kill someone.

Robert Muchamore's "Home" in which the protagonist is a very young guerilla soldier. After doing it he is nicknamed "Psycho".

Another Muchamore series has the protagonist (This time a very young super spy) shoot someone and require counseling afterward.

The whole plot of The Hunger Games books is that there's an annual event in which one boy and one girl aged 12–18 from each of the twelve districts surrounding the Capitol are selected by lottery to compete in a televised battle to the death until one winner remains.

The premise of Battle Royale is that a group of 64-ish students are taken to an island and forced to kill each other until only one survives. Adding to the "forced" aspect is the fact that they're wearing explosive collars and if no one dies for twenty four hours, the guys in charge will kill everyone...

In the Dark Disciple Trilogy this is the most terrible facet of the Children of Chemosh. This otherwise Nigh Invulnerable version of The Undead created by Chemosh can only be destroyed if a child strikes them. The destruction of the creature is so horrifying that it also traumatizes the child and robs them of their youthful innocence forever.

In A Song of Ice and Fire, nine-year old Arya Stark has to do this more than once when she's thrust into a wartorn countryside. She moves from simple self-defense to pre-meditated murder, and eventually becomes the apprentice of a guild of assassins.

The 24Made-for-TV MovieRedemption included some children being trained to kill by the followers of an African general.

On LOST, Sayid got his start in murder by covering for his brother when forced to kill a chicken. Eko did the same thing, but with a person.

In Criminal Minds episode "North Mammon" an UnSub kidnaps three girls and imprisons them in his basement cellar, he will let two of them go if they kill one of them.

The guy in "Psychodrama" tried to force young boys to kill, or otherwise just attack, their mothers under threat of death.

Supernatural: It turns out that a young Bobby Singer killed his abusive father while he was threatening his mother.

The reason the fourth episode of Hannibal was yanked from broadcast was because the killer of the week brainwashed children into killing their families. Bryan Fuller felt that it was Too Soon after certain events.

To a lesser extent in Kid Nation. The children end up having to kill chickens to feed themselves.

In the world of The Last of Us, 14 year old Ellie is forced kill not only Infected Humans but other humans too in self-defense. The Resort level particular has Ellie taking on an entire town of bandits by herself and killing their leader at the end.

Can happen in The Walking Dead. For example, Clementine can have to shoot The Stranger to save Lee if he fails to protect himself, or even shoot an infected Lee before he turns - if he tells her she has to do it.

Referenced by Lucil in Final Fantasy X-2 in which she mentions her hope of a new age "in which children will never have to lift a sword."

Example from, of all places, El Goonish Shive. Well, depending on your definition of 'child', but Susan and Nanase probably weren't much more than 12 when, during a class-trip to France, they wind up being targeted by a Somewhat Different Vampire. He's not technically human, but he LOOKS human - mostly - and while Nanase does most of the fighting, it's Susan who ends up having to kill him - with an axe, even. Unsurprisingly, she was traumatized, and the recent arc that featured the flashback culminated in an Immortal decrying the irresponsibility of the two french Immortals who originally equipped Nanase and Susan for the battle, while giving them no apparent alternative save dying at the hands of the vampire. Apparently, they could have simply informed the French Government's anti-supernatural-creature-squad instead, but elected to drag two pre-teens into a battle in order to 'recruit them for the fight against evil'.

This is standard in the setting of Drowtales, where children as young as 10 are expected to be able to defend themselves if need be, and the straightest example is when Ariel, who at the time is the equivalent of a 7 year old human child, is forced to choose between killing Mir'kiin, an asshole who had tried to kill her, and fighting her cousin to the death. She chooses to kill Mir'kiin, and it's heavily implied this leaves her with PTSD.

Survival of the Fittest: Even if you don't count the teenagers (who are usually 15-19) being forced to kill each other, there have been a few younger characters on the show as well, such as 12-year olds who did fit this.

The subject matter of Madgie, what did you do? XIX:Mercenary and, as the description put it, no one is exempt from fighting, even the youngest must fight, as in if they can hold a weapon and know what it is, they can fight.

One a side note, it's also been pointed out that Bunny was surprised that Doki (the one leading this group) was affectionate and maternal towards them and that they mean a lot to her, thus if she didn't have to, she wouldn't be putting them up to it but she has no choice and they have no choice either, as per the lines:

"In whatever war that is going on, I was surprised that Doki was very affectionate with them and it occurred to me that, due to what was going on, she didn't want to put them up to killing as so to defend their turf or themselves but it was not like she could take them anywhere else or hide them for very long. As it seemed in the case of Violetta, who was minus a leg, they would have to be damaged in sort of way if they were to be out of duty. Doki's affection towards them proved what no one thought, it proved that they were not expendable weapons and, that to her, they were precious and that, if she didn't have to, she wouldn't be making them do what they are doing."

Avatar: The Last Airbender is set in a world at war, and since the protagonists are children, it's only natural that this trope gets discussed. The protagonists face lethal confrontations with soldiers left and right (though only Sokka is unquestionably forced to kill because of it), and at one point we see a group of displaced children who are willing to kill innocent civilians for revenge against the Fire Nation.

Aang, only 12 years old, absolutely hates this. He believes all life is sacred, and he is horrified at the thought of having to kill Fire Lord Ozai. After allowing the Ocean Spirit to possess him and sink an entire Fire Navy fleet during the Siege of the North, he has nightmares about losing control and killing people while in the Avatar State.

In The Venture Bros., a clip from The Rusty Venture Show shows a young Rusty traumatically having to shoot a bad guy to save his father. Just one of the many little events that screwed up Rusty.

He also briefly mentions being forced to kill a man using a house key at age ten. Played for pitch-black laughs.

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